LRA Form 7.13
Labour Relations Act, 1995
Sections 16, 21, 22, 24, 45, 61,
74, 86, 94, 133, 141, 191, 198,
198A-C
Employment Equity Act, 1998
Sections 10
Basic Conditions of Employment
Act, 1997
Sections 41
Skills Development Act, 1998
Section 19
REQUEST FOR
ARBITRATION
(Demarcation disputes (Section 62) must be
processed on LRA Form 3.23)
1. DETAILS OF PARTY REQUESTING ARBITRATION
Read This First
Name : ………………………………………..…….………………..
…………………………………………………………………………
WHAT IS THE PURPOSE OF THIS
FORM?
If conciliation fails, a party may
request that the CCMA resolve
the dispute by arbitration.
Postal Address:………….……….……..………………..………….
…………………………………………………………Code:….……
Tel:………………….…………………. Fax:…………….…………
Cell:……………………………………..Email:…………………..…
Contact person: ………………………………………………………
WHO FILLS IN THIS FORM?
The party
arbitration.
requesting
the
WHERE DOES THIS
FORM GO?
To the Registrar at the Regional
Office of the CCMA.
This should be the same office,
which
conducted
the
conciliation.
2. DISPUTE DETAILS
The case between:
……………………....………………………….……..(referring party)
and
……………………………………………………………(other party)
was referred for conciliation, but remains unresolved.
If an accredited council or
agency is to arbitrate the
dispute, the request for
arbitration must be sent to their
offices.
The certificate of non-resolution is attached / 30 days have expired
since referral (delete whichever is not applicable).
If in doubt, contact the CCMA
for help.
…………………………………………………..………………………
The issues in dispute are ………………………………..…………
………………………………………………………..…………………
………………………………………………………………..…………
………………………………………………………………..…………
(Give a brief description. The commissioner may require a more detailed statement
of case later.)
CCMA Case Number…….…………
Please turn over
LRA Form 7.13
Request for Arbitration
Page 2 of 2
OTHER INSTRUCTIONS
3.
DETAILS OF OTHER PARTY
A copy of this form must be served
on the other party.
Name : ……………………………………………….………………..……
Proof that a copy of this form has
been served on the other party
must be supplied by attaching any
of the following:
Postal Address: ………………..…………..……………………………..
Designation:……………………………………….……………….……....
………………………………………………..……Code:…….……….….
Physical Address:………………………………….……..……………….
 A copy of a registered slip from
the Post Office; or
 A copy of a signed receipt if
hand delivered; or
 A signed statement confirming
service by the person delivering
the form;
 A copy of a fax confirmation
slip; or
 A copy of an email confirmation
slip or sent email; or
 Any other satisfactory proof of
service.
The CCMA may be requested to
assist with service.
……………………………………………..………Code:…….……….….
Tel:………………………………. Fax:……….………….………………
Cell:……………………………….Email:……………….………………..
4.
OUTCOME REQUIRED:
……………………………………………………………….…………..…
………………………………………………………………….……..……
……………………………………………………………………….…..…
…………………………………………………………………………...…
……………………………………………………………………….…..…
…………………………………………………………………………...…
CHECK!
Have you sent a copy of this
completed form to the other party?
Have you included proof that you
have sent a copy to the other
party with this form?
Have you attached the certificate
confirming that the dispute was
unresolved through conciliation?
5.
CONFIRMATION OF ABOVE DETAILS:
Form submitted by:
……………………………………………………………………………..……
(please print name)
Signature: ..............................................................................................
Position: ................................................................................................
Date: .....................................................................................................
Place.....................................................................................................
This form must be signed by the requesting party or a person entitled to
represent the party in the arbitration proceedings.